Background
The postcricoid region, pyriform sinus, and posterior hypopharyngeal wall comprise the hypopharynx. Tumors rarely appear in the posterior pharyngeal wall or postcricoid region without also involving the pyriform sinus. The lack of anatomic barriers between these sites and a propensity for these tumors to develop in the pyriform sinus and spread outward account for this phenomenon.
Overall prognosis for these tumors is poor. Because of the rich organic lymphatic and vascular networks, aggressive growth and early cervical metastases (compared with cancers at other head and neck sites) characterize these cancers.
Additionally, the nerve supply is relatively nonlocalizing (similar to that in the abdomen), which most often yields vague symptoms of discomfort as the initial presenting signs until the tumor has grown to an impressive size. Because of these factors, hypopharyngeal cancers are discovered at a later stage than other head and neck cancers. The delay in diagnosis from symptom onset averages 10 months. This fact requires that health care professionals investigate vague symptoms of a “lump in the throat” and swallowing difficulty more carefully if symptoms do not respond quickly to conservative intervention.
See the image below.
Postcricoid cancer.